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Synthetic cathinones are compounds modeled after stimulant drugs like cocaine, amphetamines, or khat, but they are made entirely in a laboratory.

The substances are dangerous and have unpredictable side effects. However, many of these substances are still legal for import into the US because the molecules are not controlled under the Controlled Substances Act or the Drug Enforcement Administration (DEA). A few, like the famous bath salts and flakka, have been made illegal by the federal government or several states. Even so, new varieties of synthetic cathinones are manufactured all the time. Although they are labeled “not for human consumption,” they are intoxicating drugs.

What Are Synthetic Cathinones?

Other names for synthetic stimulants include:

Cloud nine

Blue silk

White lightning

Meow meow

Energy-1

There are many kinds of synthetic cathinones, including flakka and bath salts. These drugs have increased in popularity since the early 2000s when they were not well known. Synthetic cathinones serve as inexpensive alternatives to other stimulant drugs, like Ritalin or cocaine.

These drugs are sold in small foil or plastic packages that generally contain 200-500 mg of the drug, with various brand names, in some of the same places that synthetic marijuana is sold. They are usually a fine white, off-white, or yellowish powder, although they are sometimes sold in capsule or tablet form. Because of the inconsistent way the drugs are manufactured, avoiding overdose is difficult even with measured sizes since each package could be chemically different from the previous one.

Risks and Dangers of Synthetic Cathinone Abuse

Synthetic cathinones are typically snorted or swallowed, although they can also be ingested through smoking, mixing them with a drink or food, or injection into a vein or muscle. Their effects and side effects are unpredictable, but most people who use these drugs display symptoms like:

Euphoria

Alertness

Increased sexual arousal or interest

Compulsion to take more of the drug often to avoid withdrawal or a “comedown”

Extreme agitation and anxiety

Increased aggression

Insomnia, or not feeling the need for sleep

Irritability and mood swings

Dizziness

Depression when the drug begins to wear off

Paranoia

Delusions

Suicidal thoughts

Seizures

Panic attacks

Hallucinations or other impaired sensory perceptions

Changes in motor control

Difficulty with cognition

Chest pain

Nosebleeds

Sweating

Nausea and vomiting

Heart attack, stroke, or damage from high blood pressure

Psychotic behaviors, including self-harm or violence toward others

Some synthetic cathinones are famed for producing euphoria and pleasurable sensations during the high. After they wear off, the person generally experiences intense depression. Other synthetic cathinones, like bath salts, are notorious for causing psychotic, aggressive effects and violent outbursts. However, no synthetic cathinone is completely predictable.

People who take synthetic cathinones put themselves at a high risk of negative side effects. For example, a survey of mephedrone users showed that:

Although synthetic cathinones are dangerous drugs of abuse, it is hard to know if the substances are physically addictive, though they can certainly be psychologically addictive. The drugs reinforce binges because they take effect quickly, and the positive effects begin to wear off quickly too. This leads the person taking synthetic cathinones to crave more, so they take more, and this puts them at high risk for overdose and death.

Due to their relative newness and constantly changing formulations, there is little empirical research regarding these drugs; however, researchers are beginning to gather better statistics about synthetic cathinone use. For example, information from the American Association of Poison Control Centers shows that in 2009, there were no calls about synthetic cathinone poisoning to US Poison Control Centers; however, in 2010, there were 302; by 2011, that number skyrocketed to 2,237 calls.

People who have sought treatment for bath salts poisoning ranged widely in age, with the majority being teenagers up to people in their early 40s.

Treatment for synthetic cathinone intoxication is likely to involve hospitalization to treat dehydration as well as heart or breathing problems, or to prevent a person experiencing a psychotic episode from self-harm or harming others. There are no drugs that stop a synthetic cathinone overdose, so emergency medical treatment addresses symptoms individually.

Once the person has safely detoxed from the drug under medical supervision, they should enter a rehabilitation program to address the substance abuse issues. The National Institute on Drug Abuse recommends that people stay in treatment for at least 90 days. A supervising doctor may prescribe those in recovery certain medications, such as antipsychotics, antidepressants, or anti-anxiety medications to ease psychological symptoms, or they may offer over-the-counter painkillers or anti-nausea medicines to ease physical symptoms.

Often, those in recovery programs for synthetic cathinone abuse will receive Cognitive Behavioral Therapy, Motivational Enhancement Therapy, or another proven therapy structure that works best for them. They must understand the root causes of their addiction and learn how to avoid specific drug-seeking and drug-taking behaviors when they experience stressful situations. With comprehensive care, addiction can be overcome.